Not nanny-state. With the opt out it created an affordable choice for parents. Without a mandate it is a a very high cost to the parents, particularly the poor and middle-class. It is only a choice if you have the financial ability to make the choice. We are not talking about choosing where to go on vacation, or what kind of car to drive. These choices are predicated on ones ability to pay for them. The choice of getting a very expensive drug that could prevent a terrible disease should not be an economic choice. Apparently you and Bachman believe that it should be, you both can afford it. Good for you. I, on the other hand, have had more than my share of medical decisions to make for a child that suffered from a horrible disease. If a vaccine could have prevented his suffering, I would have paid everything I had to pay for it. As it stands my wife and I where driven to the brink of insolvency by paying our deductibles and co-pays alone for our son. I would have gone bankrupt, sold my home and lived as a pauper to save him. Regardless, the argument helps no one. Particularly Bachman.